"Doc, can you help with a disk problem?"

This is a question I often get from my patients. The short answer is, in most cases, "Yes!" But there's a lot more to it. There are three basic types of disk problems. Also, the treatment and expected outcome will vary with the type and location of the problem.

First, let's define disk. It is a ligament that both cushions and connects one spinal vertebra with another. A disk has two parts; the nucleus pulposus, which is best described as a gelatin-like ball bearing, and the tough outer covering of anulus fibers. The anulus (ring-like) fibers connect one vertebra to another and keep the nucleus centered. The nucleus resists compression while allowing normal range of motion (ROM) of the spine and leaves room for the spinal nerves to exit the spinal column from the spinal cord.

Damage to the anulus fibers allows the nucleus to move outside its' normal ROM. This may force the anulus fibers outside the normal boundaries of the spinal column and possibly compress or stretch the spinal nerve at that level, or even put pressure on the spinal cord. If the nucleus is off center, it tends to interfere with normal ROM in that part of the spine. A disk that bulges to the outside of the spinal column tends to be easier to treat than a bulge towards the central spinal cord.

Now let's define the basic categories of disk problems in order of severity. A disk bulge extends three millimeters or less outside the normal boundary of the spinal column. This condition tends to be easier to treat. It may get better on it's own but will heal much faster if proper spinal alignment is maintained through chiropractic adjustments and muscle balancing. Observing proper lifting techniques, and the use of traction devices by a qualified professional are also very useful.

It is this doctor’s opinion that the $100,000 decompression units promoted by expensive marketing companies, in most cases, are no more effective than much more reasonably-priced flexion-distraction tables or even the hand-held devices.

A bulging disk that extends more than three millimeters outside the spinal column is defined as a protrusion and can be more serious, depending on location. The same treatment options apply with two exceptions. The side posture adjustment, in which the patient lays on one side with the top leg bent as the doctor thrusts into the lower back, should be used with extreme caution or not at all. Likewise, the rotary neck adjustment in which the head and neck is given a quick twist should be avoided in serious disk cases. A twisting motion can cause more damage to a spinal disk and is often the kind of force that caused the original injury. When properly used even with healthy disks, these types of adjustments should only be applied with the least amount of twisting possible.

The most serious disk problem tends to be the sequestered disk, where a fragment of the anular fibers has actually broken off and may move around. Although a small fragment may occasionally be reabsorbed, there is the danger that it will lodge in a spot that will cause nerve damage. These cases are the most likely to need surgery and extreme caution should be used in any adjustment procedure.

In my years of practice treating countless disk cases, there have been a handful of cases I have referred for surgery after little or no improvement. Although a majority of these cases had successful outcomes, some get worse after surgery. Back surgery can be risky and should only be considered after all other options have failed. Conservative, non invasive treatment in the form of chiropractic adjustments, decompression, and muscle balancing is much safer and usually effective. In our practice we also use Manganese Picolinate for nutritional support to help repair disks and other ligaments. Proper lifting techniques, good posture and avoiding quick twisting motions are also important for recovery.

For disk issues, a lack of proper treatment is the worst choice. It can result in progressive degeneration or thinning of the disk which compresses the spinal nerves and leads to more serious pain and/or loss of muscle function.

Dr. Rick Magly graduated from Life University College of Chiropractic after completing the pre-med program at W.Va. State College. He operates Total Health Chiropractic (304-286-2905) and is certified in Soft Tissue Orthopedics, Organ Reflex Therapy & Activator Technique & received training in sports medicine, nutrition and advanced YOGA.